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Del; -22 -10 01:41P 8509 Sunstate St. 813 886 1134 P.02 <br /> .813.780 -0020 City o f� ephyrhills Permit Application Fax -813. 780 -0021 <br /> r / /� Building Department <br /> Dale Received SM / � Phone Contact for Parmittln p 1 813 8840 .- ) (y L' � ! ' ! / S / y ' /y <br /> 1 3 Owner's Name NArl L'. Lore el Z Owner Phone Number 1 3 - IV? <br /> -1.44 <br /> Owner's Address 3 9 y 0S TT" b e fr N L O P ( Owner Phone Number F <br /> Fee Simple Titleholder Name ( 1 Owner Phone Number r <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ( 39'fc5 Tec.ber^ry 1.-0C.19 �� <br /> ,/ �� r I �" l� LOTN <br /> SUBDIVISION ( 1r ed ie.. ,o d I PARCEL ID* 1I0 — �y7 '�d i ^ O) -1. 0000 ` <br /> IOETMNED FROM PROPERTY TA( NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT 1 S IGN = [� DEMOLISH <br /> INSTALL 8 1 REPAIR <br /> PROPOSED USE = SFR 0 COMM r-- O THER 1 <br /> TYPE OF CONSTRUCTION (= BLOCK Q F FRAME r STEEL = [ I <br /> DESCRIPTION OF WORK f g/rriQC G q X1 C -■ r[l e 00C f W f4 SA vrl [. Si z C.. <br /> BUILDING SIZE ( SO FOOTAGE I 1 HEIGHT' 1 <br /> =BUILDING IS 1. 0 5 3-1 VALUATION OF TOTAL CONSTRUCTION <br /> nELECTRICAL $ I AMP SERVICE n PROGRESS ENERGY = W R.E.C. <br /> nPLUMBING $ I <br /> nMECHANICAL .$ 1 VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING O SPECIALTY F O THER <br /> FINISHED FLOOR ELEVATIONS ( I FL a eD ZONE AREA I1YES NO jj / TT <br /> SIGNATURE <br /> BUILDER f( [L! � � COMPANY (Ma r-L. ^ WU��It Jam/ ell S{Iri. �,�� <br /> v REGISTERED 1 Y/ N I FEE CURREI Y/ N <br /> Address I g501 S6ns+a , TPn 3 License N It-' ;L 1.% <br /> ELECTRICIAN COMPANY ( <br /> SIGNATURE REGISTERED 1 Y/ N I FEE CURREN 1 Y/ N <br /> Address ( 1 License N F <br /> PLUMBER COMPANY <br /> ( <br /> SIGNATURE REGISTERED I Y/ N 1 FEE CURREA I Y/N 1 <br /> Address �`'` <br /> License N l <br /> MECHANICAL COMPANY ( <br /> SIGNATURE REGLSTEREO l V/ N I FEE CURREA 1 Y/ N 1 <br /> Address I <br /> 1 License N F <br /> OTHER COMPANY ( <br /> SIGNATURE REGISTERED 1 Y/ N 1 FEE CURREN 1 Y/ N 1 <br /> Address I <br /> 1 License N <br /> 111111I11I1 1111E 11111 1ffffE111111E1f11IIIf1111111 E111f11allaalll <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans: (1) set 01 Energy Forms: R-O-W Permit for new const <br /> Minimum ten (10) working days after submittal date. Required omits. Construction Plans, Slornwatei Plans w/ Sill Fence installed, <br /> Sanitary Facilities & 1 dumpster, Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W P.trmit for new construction. <br /> Minimum ten (10) working days alter submittal date. Required onade. Construction Plans, Slormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> 1 1" 1 1 / I' 1 1' <br /> Directions: <br /> Fill out application completely. <br /> Owner £ Contractor sign back of application, notarized <br /> If over $2500, a Notlu of Commencement Is required. (A/C upgrades over $7500) <br /> Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner au horizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Retools N shingles Sewers Service Upgrades NC Fences (Plot/Survey/Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />